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An Up and Down Life

Living with Bipolar Disorder

Kathy Ringel remembers experiencing her first major depressive episode when she was just 4 years old—a tiny child weighed down with an overwhelming feeling of sadness.

Five years later, her first manic episode occurred at a friend’s house—she was full of energy, ebullient, feeling dangerously like she could do anything, anytime. “I was literally off the chain,” she says.

Over the next 27 years, Ringel would go through an increasingly frequent seesaw of emotions even as she grew up, married and had children. One week she would be pulled down by feelings of worthlessness, and the next, she would be “Wonder Woman”—staying up all night to bake cookies for homeroom, PTA president, Sunday school teacher, booster, altar guild member—all while holding down a full-time job and raising four children.

Finally, at age 36, she was diagnosed—with bipolar disorder. “For most people when they’re diagnosed, they think it’s the kiss of death,” she says. “For me, I looked at it as a gift. I know it sounds bizarre, but all the things in my life suddenly had an answer.”

An Uncommon Diagnosis

Bipolar disorder, also known as manic depression, is not common—it affects only up to 1.8 percent of the population according to Dr. Eric Lewkowiez, a child and adolescent psychiatrist at Georgia Health Sciences Health System—but those who are bipolar often suffer silently. It has only been in the past few years, as public figures such as actress Catherine Zeta-Jones and Disney star Demi Lovato have revealed their personal struggles with bipolar disorder that it has finally come out of the shadows.

Bipolar disorder is most commonly diagnosed in adolescence and young adulthood—at a time when emotions are already going through hormonal highs and lows which is why it is important not to over diagnose bipolarism, cautions Dr. Lewkowiez, especially since there are many other disorders that can mimic its symptoms, including ADHD, personality disorders, depression and medical conditions like hypothyroidism, cancer, heart disease, Parkinson’s disease and stroke.

Recent books have also stated that bipolar disorder in children can also present as temper tantrums, aggressive behavior and rages. But most psychiatrists discount this—since children who have been diagnosed with bipolar disorder based on these non-specific symptoms don’t exhibit any symptoms of classic bipolar disorder in adulthood.

Understanding the Disorder

This classic bipolar disorder is characterized by a period of overwhelming depression, followed by a period of mania, not always consecutively, both lasting a week or more. These periods can also rapidly overlap one another. And it’s not as simple as just a mood swing. In diagnosing bipolar disorder, “we compare with what’s normal,” says Dr. Lewkowiez. “It’s not just off, it’s way off. It’s really obvious what’s going on.”

“It’s really, really important that people recognize that mental illness is not a behavior, it’s a medical condition,” adds Ringel.

The depressive episodes inherent in bipolar disorder put the sufferer at high risk for suicide, while the mania can lead a patient to making wrong, even dangerous decisions that put themselves or others at risk. At her lowest, right after several traumatic events in her family, followed by the complicated birth of her youngest child, Ringel reached out to her ob/gyn, and told him flatly, “We’ve got to do something or I’m not going to be here tomorrow.”

Ringel was diagnosed with bipolar disorder soon after, and over the next decade continued to struggle with finding the right combination of medications. During one of her worst manic episodes, which occurred after a medication change, she spent three days feverishly cleaning her house with a toothbrush (“You could have eaten off that floor”), ending with her staying up all night to write a 26-page letter to her husband, begging him to take care of their children, to get married, to be happy. It was a suicide letter. Thankfully, after finishing it, she passed out from literal exhaustion, woke the next day to realize what was happening and then called her doctor and get help.

Finding the Right Treatment

Treatment options for bipolar disorder focus on medications, which can include mood stabilizers such as lithium, antiseizure medications as well as antipsychotic drugs. Because each person is different, it can take time to find the right dosage and mix of drugs, so it’s important that patients develop a good relationship with a psychiatrist for medication management, particularly if they sense the onset of a depressive or manic episode.

These medications are also why it’s important not to overdiagnose bipolar disorder—each comes with significant side effects, including increased risk of diabetes, heart disease, elevated cholesterol levels and weight gain, liver or renal failure, and more.

Certain lifestyle changes and tactics can also help manage symptoms of bipolar disorder:

• Sleep. Make sure to get a good night’s sleep. In addition, sleep changes may be a sign that an episode is about to occur.

• Avoid alcohol and other substances. These can contribute to worsening symptoms.

• Exercise. Exercise helps boost mood and combats the weight gain from medications.

• Maintain a symptom diary. A written diary helps patients track mood changes and be proactive should symptoms start to appear.

• Take a break. A quiet moment taking a breath of fresh air, or spending time doing an enjoyable hobby, can help manage symptoms.

Support is also important. After Ringel was diagnosed, she made sure to sit down with her family to explain why she had been behaving the way she had. “I’d always been the fixer,” she says. “But this time, I was not going to be able to do that. So the strategy I used was to say, ‘Come here, let’s talk about this and see if we can figure it out together,’ and that’s something I continued to cultivate. All while I was learning more and more information about mental illness.”

Ringel also began working at the Friendship Community Center on Central Avenue, a peer support center for adults recovering from emotional and mental disorders. Today she is a program director, certified peer specialist and trauma transformation peer facilitator,

helping others with mental illness, like herself, live full lives. “The best thing you can do for me if I’m having a manic or depressive episode is to ask, ‘Is there anything I can do?’” says Ringel. “Don’t be afraid I’m going to break…if there is anything you can do, I’ll let you know.”
“People with bipolar disorder who stay on their medications and get good treatment can lead very normal lives and be very productive,” says Dr. Lewkowiez. “There’s a lot of people out there with bipolar disorder who are living normal lives, have normal jobs, are well educated and having families. You just have to make alterations in your lifestyle, and it’s something that can be dealt with.”

What To Do for Someone With Bipolar Disorder

Ringel makes the following suggestions for supporting someone with Bipolar Disorder:
• Be open minded and listening.
• Be aware that this is a particular episode, not a permanent episode.
• Be there for that person.
• Don’t be condescending.
• Support, support, support.

Danielle Wong Moores is an Augusta freelance writer.

Local Support Groups

NAMI Augusta Connection Support Group for adults with mental illness, 1st and 3rd Saturdays each month, 10:30 a.m.-noon. Summerville Professional Center, Room 420, 2258 Wrightsboro Rd. (next to Trinity Hospital). Call 706- 733-8838.

NAMI Thomson Connection Support Group, every Monday, 10-11:30 a.m. Springfield Baptist Church, 523 Martin Luther King St., Thomson, Ga. Sponsor: NAMI Augusta. Contact Mrs. Wiley at 706-595-6252 or 706-595-4299 (cell).

NAMI Augusta Family Support Group, 2nd and 4th Thursdays each month, 6:30-8 p.m. Advent Lutheran Church, 3232 Washington Road. Open to family members only. Call 706-733-8838.

NAMI Aiken Family Support Group, 1st Monday each month, 7-8:30 p.m. Aiken Church of Christ (off the Bypass). Contact Lynne, 803-257-2388.

NAMI Aiken Educational Meeting, 4th Thursday each month, 7 p.m. First Baptist Church, 120 Chesterfield St. South (back entrance), Aiken. Contact Lynne, 803-257-2388.

Double Trouble in Recovery (DTR) supports people facing both mental illness and substance abuse, every Tuesday, noon to 1 p.m. Maxwell House Apartments, 1002 Greene St. (at 10th St.), back of the building. Contact Harvey Barksdale, 706399-4490 (cell).

Augusta Area Survivors of Suicide (SOS) offers grief support for friends and families of suicide victims, 4th Sunday each month, 3-5 p.m. For location or just to talk, call Laraine and Al Yarbrough, 706-863-6785.

Depression & Bipolar Support Alliance (DBSA) support group, 3rd Tuesday each month, 6:30 pm. First Baptist Church, Walton Building, Room 105, 3500 Walton Way Extension, Augusta. Contact Kathy Ringel, 706- 736-4339.

Old to new | New to old
May 2, 2012 08:41 pm
 Posted by  Aunt LuLu

Awareness is essential. Spreading the word through first person testimony is crucial for others dealing with this complex and debilitating illness.

Mad props go out to Mrs. Ringel for sharing her story with us and always being available to help in her family, friend, and community's lives.

Advocates like Mrs. Ringel are assets our community and medical community that we canNOT allow to be taken for granted.

Well done! Thank you for bringing this clouded issue to light!

May 3, 2012 01:41 pm
 Posted by  HCA

A well-written article about a beautiful person, who also happens to be at the helm of a wonderful family. Having a family member who was unsuccessful in handling bipolar disorder makes me appreciate this piece even more. Kudos (and love) to Mrs. Ringel for having the courage to discuss such a difficult and personal subject.

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